5 Commonly Misdiagnosed Conditions in Older Adults

Certain diseases are often mistaken for others. Know the differences.

It’s no mystery that time and medical conditions may accelerate changes in our bodies as we age. Eventually, some of those changes might make it more difficult to distinguish between certain conditions and the actual process of getting older.

Not only do some illnesses present differently with time, but the signs and symptoms of many of them actually start to mimic each other, making a correct diagnosis more difficult.

Here are five commonly misdiagnosed or overlooked conditions in people 50 and older along with their signs and symptoms to help guide your discussion with your doctor:

1. Urinary Tract Infection

Believe it or not, some of the more commonly noted signs of Alzheimer’s or other forms of dementia — like confusion, agitation and withdrawal — may also be present in older adults with a urinary tract infection (UTI). In addition, UTIs can exacerbate symptoms like confusion and irritability in people who already have dementia.

And, just as with other age groups, women are much more likely to get a urinary tract infection than men (mainly because women have a shorter urethra, which makes it easier for bacteria to travel into the bladder). However, these dementia-like signs tend to appear more suddenly in people with UTIs, while true dementia is more likely to appear gradually.

2. Delirium

Delirium is also commonly mistaken for dementia. Unlike dementia, delirium is normally caused by some illness or condition you may already have; scientists generally agree that disruption or blockage in brain signaling is most likely responsible for dementia.

Certain drugs — like benzodiazepines and older antidepressants — can increase confusion and reduce cognition. Hormonal disorders, nutritional deficiencies, anemia, infections, alcoholism and even atherosclerosis are just a few examples of other underlying conditions that can alter one’s mental state.

3. Essential tremor

There are a variety of conditions that cause shakiness besides Parkinson’s disease. High potassium levels and even certain medications — such as some of the older medications originally prescribed for schizophrenia like haloperidol (Haldol) or chlorpromazine (Thorazine) — can cause tremors and are known for causing “Parkinson-like” side effects.

Essential tremor is another common cause of shaking in people over 50. Some signs of essential tremor mimic those often seen in Parkinson’s disease, but essential tremor normally affects both sides of the body and the same body parts at the same time (both hands or both legs, for example). Early Parkinson’s often starts on one side of the body and then later spreads to the opposite side.

Also, many people with essential tremor tend to have a family history of the condition. And unlike Parkinson’s, which tends to affect people 55 or older, essential tremor often starts during middle age. Essential tremor is usually not a dangerous condition, but can grow worse over time, according to the Mayo Clinic.

4. Dehydration

Dehydration can be easily remedied, but left untreated, can be deadly. The condition is common regardless of whether you live at home or in a long-term care facility. As we age, the part of our brains that tells us when we are thirsty doesn’t send signals to our bodies as regularly as it once did, making us less likely to notice we’re thirsty or to recognize dehydration. Besides thirst, other early signs of dehydration include dry skin and going for long periods of time without needing to urinate.

Dehydration can aggravate or bring on other conditions, too. In severe cases, lack of hydration can also cause low blood pressure, rapid breathing and sunken eyes. Like UTIs and dementia, severely dehydrated people may appear confused and irritable; in reality, they’re delirious from poor hydration.

5. Fibromyalgia

Statistics show that nearly 50 percent of people ages 65 and older have been diagnosed with some form of arthritis. Unfortunately, many symptoms of rheumatoid arthritis resemble those found in patients with fibromyalgia and lupus. These conditions often affect many of the same joints in a similar way, causing pain, stiffness and aching. However, despite joint discomfort, people with fibromyalgia do not normally experience the swelling noted by rheumatoid arthritis and fibromyalgia doesn’t normally affect the same joints in the hands that rheumatoid arthritis does. Still, because of the similarity in the symptoms, your doctor may have to run tests to tell you which condition you have.

The bottom line: We sometimes overlook warning signs from our bodies that something may be wrong. Try to listen to your body, paying close attention to any unusual changes you may notice. Never be afraid to talk to your doctor, and don’t hesitate to follow up if your symptoms haven’t improved after a reasonable amount of time or if something still “just doesn’t feel right.”

Frieda Wiley, PharmD, CGP, RPh, is a board-certified geriatric pharmacist and freelance medical writer based in the Piney Woods of East Texas. She enjoys using her background in patient care to empower people with more knowledge about living well.@frieda_wiley